The Peter Attia Drive - #370 - AMA #76： Peter evaluates longevity drugs, aspirin for CVD, and strategies to improve muscle mass — proven, promising, fuzzy, noise, or nonsense？

00:00:00.000 Hey everyone, welcome to a sneak peek, ask me anything or AMA episode of the drive podcast.

00:00:15.820 I'm your host, Peter Atiyah. At the end of this short episode, I'll explain how you can access

00:00:20.280 the AMA episodes in full, along with a ton of other membership benefits we've created,

00:00:24.900 or you can learn more now by going to peteratiyahmd.com forward slash subscribe.

00:00:30.600 So without further delay, here's today's sneak peek of the ask me anything episode.

00:00:38.800 Welcome to ask me anything AMA episode number 76. In today's AMA, we revisit the proving,

00:00:47.060 promising, fuzzy, noise, nonsense scale and apply it to a variety of commonly inquired about and

00:00:54.560 hot button topics. We start with a quick reset on what each bucket means and define them, of course,

00:01:00.720 and then we walk through every topic where we're going to land on. So the goal of this episode is

00:01:05.720 that if you're coming to this topic without any previous background, or you just want the TLDR,

00:01:10.940 this is the place for you. We group the topics by the intended outcome. There are three categories

00:01:16.220 today. Drugs for gyroprotection, where we cover GLP-1 agonists, SGLT-2 inhibitors, methylene blue,

00:01:23.640 and telomere lengthening supplements. Talk about low dose aspirin for CVD prevention. And then we

00:01:30.700 look at interventions to improve muscle mass, talking specifically about protein, but also

00:01:36.000 folistatin gene therapy. If you're a subscriber and want to watch the full video of this podcast,

00:01:41.360 you can find it on the show notes page. And if you're not a subscriber, you can watch the sneak

00:01:46.280 peek of this video on our YouTube page. So without further delay, I hope you enjoy AMA 76.

00:01:51.960 All right. Peter, Artia, doctor, podcaster, author, speaker, bad chess player. How are you doing

00:02:08.920 today? Hey, hey, hey, hey, hey, hey, hey. You could say shepherd in there. You don't have to,

00:02:13.020 you don't have to take sheep shots. Shepherd of diabetic sheep, race car driver. Anything else

00:02:21.020 missing? Oh, that's good. That's good. All right. I just didn't want to forget the diabetic sheep

00:02:26.620 out there. That's true. That's true. How's the day going today? Started out good. Then took a little

00:02:32.140 dip with the follow-up chess match, but there's a recurring theme here that you, I know you just

00:02:37.840 love picking this scab. Well, I just, sometimes you think about feats like Tom Brady, right? Like

00:02:45.260 what he went through. Greatest of all time, right? Yeah. People who come back from injuries.

00:02:50.600 Tamar Hamlin, like almost died, came back and played. I mean, like you getting second in a four

00:02:57.380 person in-house chess tournament with two children has to be up there, right? Listen,

00:03:04.220 we all started playing at the same time. Pogacar just won the tour again, went through two in a row,

00:03:13.300 grueling, not as mentally tough as what you went through though, a month ago.

00:03:19.060 I would argue what I go through on the daily, trying to just make sure I don't get beat by an eight-year-old

00:03:26.240 in chess is at least on par mentally with some of the feats you're talking about.

00:03:32.340 We need to have Tom on the podcast and you should ask him about it. Which one was harder? All those

00:03:37.460 Super Bowls. Is it harder to be down 28 to three, having thrown a pick six in the Super Bowl or

00:03:45.660 succumbing to an eight-year-old's gambit, which is tougher? To be fair, there is a real chance the

00:03:54.120 eight-year-old might've talked more trash than what was going on in the Super Bowl, which says

00:03:58.440 something. Yep. All right. So today's AMA, not about chess, going to be a little different.

00:04:07.560 So what we're going to do is cover a variety of topics, looking at it through a certain lens,

00:04:12.280 which is we are going to take concepts and things that we've talked about before, some new things

00:04:18.720 that we haven't talked about before, that we get asked about a lot. And instead of going super deep

00:04:23.840 in them, we're going to kind of summarize them into how you think about them. And we're going to do it

00:04:28.880 into five different buckets. And those buckets are proven, promising, fuzzy, noise, nonsense.

00:04:36.260 People who have listened for a bit will remember this. We did this in episode 300 of the podcast,

00:04:40.840 which was back in May, 2024. So it's been a little bit, but people really liked it because it allowed us to

00:04:46.700 cover a variety of topics. It allowed us to summarize them and it allowed us to kind of look

00:04:52.320 at them in apples to apples comparison with what we know about them and how people should be thinking

00:04:56.880 about it. So in today's episode, we are going to look at some geroprotective drugs like GLP-1s,

00:05:04.480 things like Ozempic, SGLT2 inhibitors, both of which we talked about before. We're going to look at

00:05:09.800 methylene blue and telomere lengthening supplements. Those are kind of newer. We're going to look at what we

00:05:15.160 know about low-dose aspirin and cardiovascular disease prevention. And then we're going to look

00:05:20.000 at interventions that can help improve muscle mass, things like protein, folistatin gene therapy,

00:05:26.440 et cetera. Hopefully a good variety of things for people. Hopefully kind of a way to go through it

00:05:32.960 where people can kind of look, get clear, clean takeaways. With that said, anything you want to add

00:05:40.440 before we get rolling? No, but maybe I will just remind people or for folks who are new to the

00:05:47.820 program, what these categories mean. So you mentioned five and we're starting from the most

00:05:54.120 promising or the closest to quote unquote truth, which we're calling proven. Although I put proven

00:06:00.460 in quotes because technically nothing in biology is proven, right? It's not like mathematics where you

00:06:06.060 prove something and write QED at the end and never have to think about it again. So proven would be

00:06:11.420 as close to well-established claim as you're going to find. The implication for us, of course, is you've

00:06:17.480 got lots of high quality, consistent data. The category beneath that would be promising. This is a

00:06:22.960 category where the claims look good. There are data to support it, but maybe we're still waiting on

00:06:29.180 replication or maybe most of the data are moving in one direction, but not all of it or something like

00:06:34.520 that. Category beneath that we call fuzzy. And this means there are some data around the claim,

00:06:40.860 but they are really inconsistent and incomplete. So overall, you would say the data quality here is

00:06:47.300 not that great, but there's probably a signal. Beneath that, we have noise. So here we have

00:06:54.480 something where there are just frankly no real meaningful results. So noise is something that,

00:07:01.620 it's not that I'm saying you shouldn't pay attention to it, but you clearly don't want to be

00:07:06.440 distracted by it. And it's best to wait and see if noise declares itself by going up to fuzzy with the

00:07:13.700 presence of some data as it works its way up the chain or whether data actually emerge that put it

00:07:20.360 in the final category, which is actual nonsense. So again, nonsense means we actually have data and the

00:07:27.020 data refute the claim being made. So as far as we can tell, this is as close to disproven as you'll

00:07:33.680 be. So again, those are the five categories. Just kind of keep that in mind as we apply our judgments

00:07:37.680 to these things and keep in mind as well that these are fluid. Things can move up and down these chains

00:07:42.840 in the presence of new information. Yeah. And I think I always like to anchor people to this. And so

00:07:49.260 we've talked about it before, but I do think it's helpful, which is sometimes I think in today's day and age

00:07:54.240 where people are very confident in their opinions and usually kind of stick to them. You see it a lot

00:08:00.700 in nutrition where it's like, you just get in a camp and you stay with it. Do you just want to talk a

00:08:05.540 little bit about your idea of strong convictions, loosely held and why you think it might be

00:08:11.160 counterintuitive when people change mind and something goes from proven to promising or it goes

00:08:16.300 up and down, but just how you think about when new data comes, you just have to be

00:08:21.740 unemotional to it and just take signs for science. Yeah. Look, I think first and foremost,

00:08:28.500 that's an attribute of great scientists. So if you look at what separates good scientists from

00:08:33.300 great scientists, that would probably be one of the characteristics. A great scientist is not married

00:08:39.600 to being right. They're married to knowing what is right and they're going to go wherever the data

00:08:45.320 take them. But honestly, the first time I heard that expression to have strong convictions loosely

00:08:51.180 held was actually from a friend of mine who at the time was running a hedge fund. He's since retired,

00:08:55.880 but he said, look, that's the key to being a good investor is you have to have strong convictions

00:09:01.520 because you're going to be putting a lot of capital at risk, but those convictions have to be

00:09:06.140 loosely held. So the moment that data emerge, the change your thesis for investment, you have to be

00:09:12.900 flexible enough to move as opposed to double down. And the reason I think that this is such an

00:09:17.800 important part of investing is in science, if you're wrong, the price is not that severe.

00:09:24.420 In fact, without calling out or embarrassing anybody, there are lots of people who have taken

00:09:28.620 positions on things that are just so patently incorrect 20 and 25 years later, and yet they just

00:09:34.680 can't let go of their baby. They can't kill their baby. And so frankly, they just make fools out of

00:09:41.060 themselves continuing to cling to ridiculous beliefs, but there's actually no real price they're

00:09:46.760 paying for that other than within the scientific community they're laughed at. But you can't be an

00:09:52.200 investor. You can't be a money manager with that type of mentality because you'll be out of business.

00:09:58.660 And so in the final analysis, the dollars talk louder than anything else. And if you continue to

00:10:04.420 double down on horrible positions, you will lose the money of your LPs and ultimately you will be broke.

00:10:11.060 So I think that's sort of why it's a great idea to be thinking about through the lens of how an

00:10:15.100 investor functions. And so I think we just have to all try to do that. It's hard. It's hard to kill

00:10:19.560 your babies, but that was the expression. Those were the exact words that were used when I first showed

00:10:24.240 up in the lab and first started doing experiments and first started getting my data and trying to put

00:10:30.600 hypotheses together and make sense of what I was seeing. You can have the most beautiful,

00:10:35.580 beautiful hypothesis ever. And it can be categorically slayed by ugly facts. And that's

00:10:40.960 paraphrasing a quote. God, I don't remember who actually said that quote, but it's a sort of famous

00:10:45.740 quote in science. Yeah. I think it's just good for people to kind of anchor that too. So starting off,

00:10:51.320 if you had to put the following statement into one of those categories, where would it be? Which is

00:10:57.360 the next in-house tournament, Peter Atiyah takes first place?

00:11:03.060 Listen, I believe I have the potential to beat my young boys in chess, provided I don't get

00:11:11.640 distracted by the smack talk. In my defense today, by the way, I know you don't play chess, but just so

00:11:17.360 you understand, I promoted a pawn to a second queen on the 25th move. Do you understand what an

00:11:24.520 advantage I had in this game today? I've got two queens on the board and I was ahead on material

00:11:30.480 before that promotion. This was a bloodbath. And then he starts yapping so much and makes what

00:11:40.100 looks like an idiotic blunder, exposing his rook to my newest queen. So of course I take the free rook,

00:11:48.560 but I was so dumb when I did it that I didn't notice that he moved his bishop out of the way

00:11:54.420 what looked like a blunder. So he sacrificed his rook to put his bishop in a way to basically

00:12:00.380 create what's called a battery against my king. And the next move, he checkmated me.

00:12:07.040 So you could say, okay, I got beat. Yes, I did. But part of it is I was distracted by how much he

00:12:12.860 was yapping. So all I really need to do to up my game is just not get distracted. I think I have a

00:12:18.260 good chance to win the next in-house tournament. I do love your kryptonite is second graders who

00:12:25.100 talk trash, whether it's chess, whether it was the kid who was just giving you tons of crap for

00:12:31.740 drinking a diet soda at the school lunch, wherever it is. There could literally be a sitcom of me

00:12:39.160 going through my life, just getting broken down by eight-year-olds, just getting put in my place.

00:12:46.560 It's like the Seinfeld episode where the shrimp comment, a day later, he rethinks of what the

00:12:53.460 comeback should have been. I just anticipate that's you like going to sleep at night being like,

00:12:58.500 oh man, when Aries said this, if I would have responded with this, I would have got him so bad.

00:13:04.900 Next time, next time, I'm not going to let that eight-year-old talk that trash to me.

00:13:10.840 So good.

00:13:11.140 Well, real thing we're going to start with, geoprotective drugs. So there's a lot of

00:13:17.020 questions about drugs that have metabolic health effects and what that means for anti-aging.

00:13:25.560 So instead of just looking at this improves metabolic health, is there something special

00:13:30.400 about those that can also be anti-aging? And on a side note, just it'll be good to explain what

00:13:36.200 geoprotective drugs are. We've done it before, but I think it's good for a quick reminder. But

00:13:41.140 outside of that, the biggest drug that is in the news all day, every day, GLP-1s,

00:13:46.980 Ozempic, Trisepatide, Wigovi, you name it, everyone's heard of it. We've done a lot about

00:13:52.040 that. So the question is, do we know anything if they have a unique anti-aging effect that actually

00:13:59.360 improves lifespan outside of the metabolic health effects they have?

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The Peter Attia Drive - October 27, 2025

#370 - AMA #76： Peter evaluates longevity drugs, aspirin for CVD, and strategies to improve muscle mass — proven, promising, fuzzy, noise, or nonsense？

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